Complex spasticity management clinic - Information for patients Mobility and Specialised Rehabilitation - Sheffield Teaching ...
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Complex spasticity
management clinic
Information for patients
Mobility and Specialised Rehabilitation
PROUD TO MAKE A DIFFERENCE
SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUSTpage 2 of 8
The Princess Royal Spinal Injuries and
Neurorehabilitation Centre
Osborn Building
Northern General Hospital
Herries Road
Sheffield
S5 7AU
Telephone: 0114 271 5651
Facsimile: 0114 271 5649
Minicom: 0114 271 5896
page 3 of 8What is spasticity?
Spasticity is a condition in which certain muscles become excessively
contracted, causing a stiffness or tightness.
This will interfere with the way those muscles work and how well you
can use them.
It is a common problem in diseases such as:
• Stroke
• Brain injury, e.g. head injury
• Multiple sclerosis
• Cerebral palsy
• Spinal cord injury
• Damage to the brain because of lack of oxygen
The degree of spasticity will vary from a mild stiffness to severe and
painful muscle spasms, as well as loss of function (how well you can use
those muscles).
Why treat spasticity?
Spasticity is treated because it interferes with muscle function or care
needs. You may find it difficult to perform basic activities such as eating
or dressing; or you may experience severe pain and difficulty in
maintaining a proper body position or in walking. Carers may also find
it difficult to help you if your spasm is severe.
In the long term, muscle stiffness can become fixed, with changes in the
muscles and soft tissues leading to a permanent deformity or
contracture.
page 4 of 8What is the complex spasticity management clinic?
This is held at the Northern General Hospital on Fridays.
On referral to the clinic, you will be seen by a multidisciplinary team to
assess the extent to which spasticity is a problem for you. By talking to
you (and your carers and therapists), we can come to an agreed decision
about what will be the best plan of treatment for you.
The clinic is led by a consultant physician in rehabilitation medicine with
the help of specialist doctors, therapists and technicians, all of whom
have expertise in the treatment and management of spasticity. Having
all these skills in the one place means that you will get a high quality
multidisciplinary service.
What treatments do you offer?
There are a number of different treatments that we can offer, but it is
important to emphasise that it is a combination of treatments that
works, as no one medication or treatment can work by itself.
• For generalised spasticity (e.g. affecting two or more limbs),
oral medication (taken by mouth) is often useful. There are a
number of different drugs that can be used, but these should be
assessed by an expert at the clinic.
• For localised treatment, muscle or nerve blockade may be
appropriate, depending on the pattern of muscles affected.
• Another common treatment that you may have heard of is
Botulinum toxin (often known as Botox), which can be very
effective when applied to specific muscles. It should be used with
caution, as it is a poison and the effects of injection can last up to
six months on individual muscles.
page 5 of 8• Physiotherapy is an integral part of treatment, from specialists
trained in neurorehabilitation. Without an appropriate course of
physiotherapy, no treatment will be effective.
• Similarly, the use of appropriate splinting and orthoses is an
important part of treatment provided by the department.
Other forms of treatment can be very effective in particular people:
• Functional electrical stimulation involves the use of a small electric
current to assist normal or weakened muscles to overcome the
effects of overactive muscles from spasticity.
• Intrathecal Baclofen pumps and other surgical options can also be
useful when the effects of spasticity are particularly severe and
other treatments have not proved effective.
• Assessment of problems with balance or walking can be assessed
using our clinical gait lab to good effect.
What happens at the clinic?
You will be assessed by a multidisciplinary team. After we have agreed
whether treatment is necessary, and whether it will affect the function
you have in your muscles, we will look at the treatment options.
We will then set goals along with you and any carers or family. We will
try to involve your therapists in this process as well.
The goals in your case might be, for example, to improve function,
decrease the frequency of spasms, or lessen the degree of pain
associated with such muscles.
Alternatively, we may try to make any care that you receive easier to
provide, e.g. help with dressing or positioning.
page 6 of 8Occasionally, we can improve voluntary motor function and improve
walking or the use of a limb, for example enabling you to grip and
release objects.
Once appropriate goals and treatment have been decided on and
carried out, we will review you again in clinic to see whether the goals
and treatment have been effective. We can then decide on whether any
further treatment is required.
What if I have any questions?
There is always time to discuss queries that you may have about your
treatment; please address them to either:
Dr Rajiv Singh
Consultant in Rehabilitation Medicine, Northern General Hospital
or
Alison Clarke
Clinical Specialist Physiotherapist, M&SRC, Northern General Hospital
• Telephone: 0114 271 5651
• Fax: 0114 271 5649
• e-mail: rajiv.singh4@nhs.net or alison.clarke36@nhs.net
page 7 of 8Alternative formats can be available on request. Please email: sth.alternativeformats@nhs.net © Sheffield Teaching Hospitals NHS Foundation Trust 2021 Re-use of all or any part of this document is governed by copyright and the “Re-use of Public Sector Information Regulations 2005” SI 2005 No.1515. Information on re-use can be obtained from the Information Governance Department, Sheffield Teaching Hospitals. Email sth.infogov@nhs.net PD6784-PIL2580 v5 Issue Date: August 2021. Review Date: August 2024
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